Performance of Examinees from Foreign Schools on the Clinical Science Component of the United States Medical Licensing Examination

Summary

In 1993, the successful completion of Steps 1 and 2 of the United States Medical Licensing Examination (USMLE) became the sole examination route for students in or graduates of foreign medical schools (FMGs) to gain entry into graduate training in the United States. This paper reports on selected demographic characteristics of the 48,858 FMGs sitting for USMLE Step 2 during the 1994 and 1995 academic years and presents the results of descriptive analyses of the relationship between these characteristics and examination performance. The Step 2 pass rate for the FMGs was 41% in the total group and 48% for first time takers. Nearly 57% of examinees sat for Step 2 at US test sites, 80% sat for the exam one or more years after graduation, 57% were 30 years of age or older, 65% were men, and 11% were native English speakers. In terms of performance, firsttakers, younger examinees, recent graduates, and native English speakers tended to perform better overall than their counter parts. As a group, FMGs tended to score highest on topics in surgery and lowest in preventive medicine and psychiatry. Because there is little information about which FMGs decide to sit for Step 2, inferences are limited and performance differences cannot be interpreted as an indicator of the quality of medical education or care provided in a given country.